Provider Demographics
NPI:1972541324
Name:LABORATORIO CLINICO MARIELYS, INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO MARIELYS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-787-8800
Mailing Address - Street 1:PO BOX 3310
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00958-0310
Mailing Address - Country:US
Mailing Address - Phone:787-787-8800
Mailing Address - Fax:787-786-0883
Practice Address - Street 1:E-29 AVE HERMANAS DAVILA
Practice Address - Street 2:URB SAN FERNANDO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-2202
Practice Address - Country:US
Practice Address - Phone:787-787-8800
Practice Address - Fax:787-786-0883
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LABORATORIO CLINICO MARIELYS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-04
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0489291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory